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18F-FDG PET/CT 检测原发性病变代谢参数在子宫内膜癌术前评估中的价值。

Value of metabolic parameters of primary lesions examined by 18F-FDG PET/CT for endometrial cancer in preoperative evaluation.

机构信息

Department of Medical Imaging, Yantaishan Hospital, Yantai, China.

出版信息

Eur Rev Med Pharmacol Sci. 2021 Mar;25(6):2493-2502. doi: 10.26355/eurrev_202103_25412.

Abstract

OBJECTIVE

To evaluate metabolic parameters of primary lesions examined by 18F-FDG PET/CT (18Fluorodeoxyglucose Positron Emission Tomography /Computed Tomography), including maximum standard uptake value (SUVmax), metabolic volume (MTV), and total lesion glycolysis (TLG).

PATIENTS AND METHODS

79 patients with endometrial cancer were selected as the subjects. They were diagnosed by histopathology in our hospital for the first time from January 2016 to December 2018. All the patients were examined by 18F-FDG PET/CT. Retrospective statistical analysis was carried out to evaluate different expression of metabolic parameters examined by 18F-FDG PET/CT of different clinicopathologic factors in endometrial cancer. Spearman correlation analysis was also used.

RESULTS

SUVmax, TLG and MTV were correlated with FIGO staging, tissue grading, depth of myometrial invasion, and lymph node metastasis. SUVmax, TLG and MTV in lymph node metastasis group had high clinical staging, low differentiation and myometrial invasion depth >1/2, which were significantly higher than those in no lymph node metastasis group (low clinical staging, high differentiation and myometrial invasion depth ≤1/2). TLG had the greatest difference(p<0.001). TLG and MTV were correlated with histopathological classification (p<0.05). The expression levels of SUVmax, MTV and TLG of primary lesions were negatively correlated with the positive expression of ER and PR in tumor tissues (p<0.05), and significantly positively correlated with positive expression of HER -2 and Ki-67 (p<0.01). The expression of ER, PR, HER-2 and KI-67 in tumor tissues was correlated with tissue grading, clinical staging, depth of muscular layer infiltration, cervical tissue involvement and lymph node metastasis (p<0.05).

CONCLUSIONS

Metabolic parameters of primary lesions examined by 18F-FDG PET/CT has a good correlation with its clinicopathological features. They can provide reference for the preoperative formulation of treatment plan for endometrial cancer, so as to reduce the risk of surgery and improve the prognosis of patients.

摘要

目的

评估 18F-FDG PET/CT(氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描)检查的原发性病变的代谢参数,包括最大标准摄取值(SUVmax)、代谢体积(MTV)和总病变糖酵解(TLG)。

患者和方法

选择我院 2016 年 1 月至 2018 年 12 月首次经组织病理学诊断为子宫内膜癌的 79 例患者为研究对象。所有患者均接受 18F-FDG PET/CT 检查。对不同临床病理因素的子宫内膜癌患者 18F-FDG PET/CT 检查代谢参数的不同表达进行回顾性统计分析,并进行 Spearman 相关性分析。

结果

SUVmax、TLG 和 MTV 与 FIGO 分期、组织分级、肌层浸润深度和淋巴结转移有关。SUVmax、TLG 和 MTV 在淋巴结转移组的临床分期较高、分化程度较低、肌层浸润深度>1/2,与无淋巴结转移组(临床分期较低、分化程度较高、肌层浸润深度≤1/2)相比,差异有统计学意义(p<0.001)。TLG 差异最大(p<0.001)。TLG 和 MTV 与组织学分类相关(p<0.05)。原发性病变 SUVmax、MTV 和 TLG 的表达水平与肿瘤组织中 ER 和 PR 的阳性表达呈负相关(p<0.05),与 HER-2 和 Ki-67 的阳性表达呈显著正相关(p<0.01)。肿瘤组织中 ER、PR、HER-2 和 KI-67 的表达与组织分级、临床分期、肌层浸润深度、宫颈组织受累和淋巴结转移有关(p<0.05)。

结论

18F-FDG PET/CT 检查的原发性病变的代谢参数与临床病理特征具有良好的相关性。它们可以为子宫内膜癌的术前治疗方案制定提供参考,以降低手术风险,改善患者预后。

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